Provider Demographics
NPI:1588810956
Name:HAGOS, HANA TSEGE (MD)
Entity type:Individual
Prefix:
First Name:HANA
Middle Name:TSEGE
Last Name:HAGOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7866 GALL BLVD
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33541-4302
Mailing Address - Country:US
Mailing Address - Phone:813-492-5732
Mailing Address - Fax:
Practice Address - Street 1:7866 GALL BLVD
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33541-4302
Practice Address - Country:US
Practice Address - Phone:813-492-5732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-17
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV29582207Q00000X, 207Q00000X
FLME166529207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIHH85548Medicaid